梗阻性黄疸与肠粘膜屏障功能的实验研究

Abstructive jaundice and changes of the function of intestinal mucosal barrier in rats

目的 了解梗阻性黄疸时小肠粘膜的病理改变。方法 无菌条件下结扎大鼠总胆管 ,取末端回肠观察其组织学改变。测量小肠粘膜的绒毛高度 ,绒毛面积和肠粘膜厚度 ;计算内脏细菌移位率。结果 在光镜下观察到总胆管结扎组肠粘膜萎缩 ,绒毛水肿 ,部分上皮细胞脱落 ;绒毛平均高度、绒毛平均面积和粘膜平均厚度减少。在电镜下观察到微绒毛稀疏 ,排列紊乱 ,内质网数目少且结构不完整 ;线粒体数目少 ,轻度肿胀 ,膜不清楚 ,嵴少而乱 ,内有空泡。肠系膜淋巴结、肝脏和脾脏的细菌移位率明显增加 ,移位的细菌主要是大肠杆菌和变形杆菌。结论 梗阻性黄疸时肠粘膜屏障功能严重受损 ,导致肠源性感染的发生。

Objective To investigate the changes of intestinal mucosal barrier in rats with abstructive jaundice. Method Using sterile technique the rat common bile ducts were ligated. Terminal ileum specimen were taken for histologic examination observing villus height, villus surface area, mucosal thickness and bacterial translocation incidence were measured. Results Pathologic changes in CBDL group included mucosa atrophy,villus edema,falling of part of epitheilia.By electron microscopy,microvilli rarefaction and irregularity were seen. The number of the endoplasmic reticulum was few and its structure was damaged. The mitochondria were slightly swelled and its number was few, the number of cristae was few and its structure was damaged. Bacterial translocation incidence of the mesenteric lymph node complex,liver and spleen was increased. The major bactaria were E.coli and Proteus. Conclusion Obstructive jaundice causes the injury of intestinal mucosal barrier and leads to gut originated sepsis.